RESUMEN
Radical cystectomy is the current treatment of choice for patients with BCG-unresponsive non-muscle invasive bladder tumor (NMIBC). However, the high comorbidity of this surgery and its effects on the quality of life of patients require the investigation and implementation of bladder-sparing treatment options. These must be evaluated individually by the uro-oncology committee based on the characteristics of the BCG failure, type of tumor, patient preferences and treatment options available in each center. Based on FDA-required oncologic outcomes (6-month complete response rate for CIS: 50%; duration of response in responders for CIS and papillary: 30% at 12 months and 25% at 18 months), there is not currently a strong preference for one treatment over another, although the intravesical route seems to offer less toxicity. This work summarizes the evidence on the management of BCG-unresponsive NMIBC based on current scientific evidence and provides consensus recommendations on the most appropriate treatment.
Asunto(s)
Adyuvantes Inmunológicos , Vacuna BCG , Invasividad Neoplásica , Neoplasias de la Vejiga Urinaria , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/terapia , Humanos , Vacuna BCG/uso terapéutico , Vacuna BCG/administración & dosificación , Adyuvantes Inmunológicos/uso terapéutico , Cistectomía/métodos , Insuficiencia del Tratamiento , Administración Intravesical , ConsensoRESUMEN
Desmoplastic small round cell tumor is a very rare neoplasm, that usually appears in children and young adolescents. There is no standard therapy, and responses to chemotherapy are infrequent. Surgery is still the main treatment for this disease. We report the case of a 39 year-old man and briefly summarize the evidence about this tumor (AU)
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Asunto(s)
Masculino , Adulto , Humanos , Neoplasias Peritoneales/diagnóstico , Neoplasias Peritoneales/tratamiento farmacológico , Sarcoma de Ewing/diagnóstico , Progresión de la Enfermedad , Sarcoma de Ewing/tratamiento farmacológico , Sarcoma de Células Pequeñas/complicaciones , Sarcoma de Células Pequeñas/diagnóstico , Sarcoma de Células Pequeñas/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Resultado Fatal , Ganglios Linfáticos/patología , Metástasis de la Neoplasia , Neoplasias Peritoneales/patología , Peritoneo/patología , Pronóstico , Sarcoma de Ewing/patología , Sarcoma de Células Pequeñas/patología , Resultado del TratamientoRESUMEN
Glucagonoma is an uncommon disease, a neuroendocrine tumour that develops from glucagon-producing pancreatic cells. They are usually slow-growing, but generally advanced at diagnosis, and metastatic disease is virtually incurable. Liver is the most common site of metastatic disease. We present the case of a 48-year-old man with a glucagonoma being diagnosed from a pulmonary mass. This case had no liver affection in the whole evolution of the disease, and showed a particularly aggressive course, with very little response to all therapies administered, and a survival from diagnosis of just 16 months (AU)
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Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Glucagonoma/secundario , Neoplasias Pulmonares/secundario , Neoplasias Pancreáticas/patología , Resultado Fatal , Glucagonoma/fisiopatología , Glucagonoma/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Diagnóstico Diferencial , Neoplasias Pulmonares/terapia , Neoplasias Pancreáticas/fisiopatología , Neoplasias Pancreáticas/terapia , Tomógrafos Computarizados por Rayos XRESUMEN
The hematopoietic growth factors (HGFs) are a family of glycoproteins which plays a major role in the proliferation, differentiation, and survival of primitive hematopoietic stem and progenitor cells, and in the functions of some mature cells. More than 20 different molecules of HGF have been identified. Among them, granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been demostrated to be effective in reducing the incidence of febrile neutropenia when administered inmediately after chemotherapy and as supportive therapy in patients undergoing bone marrow transplantation. Chemotherapy used for treatment of cancer often causes neutropenia, which may be profound, requiring hospitalization, and leading to potentially fatal infection. The uses of the recombinant human hematopoietic colony-stimulating factors G-CSF and GM-CSF for treatment and prophylaxis of chemotherapy-induced febrile neutropenia will be reviewed here (AU)
Asunto(s)
Humanos , Anciano , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Trasplante de Médula Ósea , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Factor Estimulante de Colonias de Granulocitos/efectos adversos , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Factor Estimulante de Colonias de Granulocitos y Macrófagos/administración & dosificación , Factor Estimulante de Colonias de Granulocitos y Macrófagos/efectos adversos , Factor Estimulante de Colonias de Granulocitos y Macrófagos/uso terapéutico , Fiebre/inducido químicamente , Fiebre/prevención & control , Enfermedad Aguda , Interpretación Estadística de Datos , Inyecciones Subcutáneas , Leucemia Mieloide/tratamiento farmacológico , Neutropenia/inducido químicamente , Neutropenia/prevención & control , Ensayos Clínicos Controlados como Asunto , Factores de Tiempo , Factores de Riesgo , Neoplasias/tratamiento farmacológico , Neoplasias/radioterapia , Metaanálisis como AsuntoRESUMEN
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